Abstract 14599: Association of Fibrillation Cycle Length on the Surface Electrocardiogram With Clinical Outcomes in Atrial Fibrillation Patients: The Fushimi AF Registry

Abstract

Background: It is unknown whether fibrillation cycle length (FCL) on the surface electrocardiogram is associated with clinical outcomes in patients with atrial fibrillation (AF). Methods: The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients in Fushimi-ku, Kyoto. The FCL was calculated using spectral analysis of the fibrillation waves on the surface electrocardiogram in 966 patients (mean age; 73.2 years, female; 40.9%, mean CHA 2 DS 2 -VASc score; 3.21) with AF at baseline. We assessed the association of FCL with the demographics and clinical outcomes. Results: Median FCL was 163.8 ms (interquartile range; 148.0, 195.0 ms). We divided the patients into 2 groups: 524 patients with FCL ≥163 ms and 442 patients with FCL<163 ms. Patients with longer FCL were older (74.6 vs. 71.7 years of age; p<0.01), more often female (49.6% vs. 30.5%; p<0.01), more often paroxysmal type of AF (55.2% vs. 33.3%; p<0.01), had lower body weight (58.6 vs. 61.8 kg; p<0.01), higher heart rate (93.1 vs. 86.3 /min; p<0.01), higher CHA 2 DS 2 -VASc score (3.41 vs. 2.98; p<0.01). They were more likely to have history of heart failure (HF) (25.8% vs. 19.5%; p=0.02), valvular heart disease (24.1% vs. 15.6%; p<0.01), coronary artery disease (18.9% vs. 12.7%; p<0.01), and chronic kidney disease (38.6% vs. 26.2%; p<0.01). During the median follow-up of 2,194 days, all-cause mortality occurred in 99 patients (3.5 /100 person-years) with longer FCL and 55 patients (2.2 /100 person-years) with shorter FCL, with an adjusted hazard ratio of 1.46 (95% confidence interval [CI], 1.01-2.13; p=0.043), adjusted by age, sex, body weight, heart rate, type of AF and comorbidities. Adjusted hazard ratios of stroke or systemic embolism and hospitalization for HF for longer FCL were 1.23 (95%CI, 0.73-2.11; p=0.44) and 2.29 (95%CI, 1.52-3.50; p<0.01), respectively. Conclusion: The FCL on surface electrocardiogram was associated with higher mortality and incidence of hospitalization for HF in Japanese AF patients enrolled in the Fushimi AF Registry.